Doomed Interventions: The Failure of Global Responses to AIDS in Africa.
Authors: Ennis B PMID: 32063138 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - February 20, 2020 Category: African Health Tags: Afr J AIDS Res Source Type: research

Meta-analysis of average costs of HIV testing and counselling and voluntary medical male circumcision across thirteen countries.
Authors: Pineda-Antunez C, Martinez-Silva G, Cerecero-Garcia D, Alexander L, Cameron DB, Chiwevu C, Dandona L, Obure CD, Forsythe S, Nguyen VT, Settumba S, Tchuenche M, Van Minh H, Kahn JG, Gomez G, Sweeney S, Vassall A, Bollinger L, Levin C, Bautista-Arredondo S Abstract Objective: Explore facility-level average costs per client of HIV testing and counselling (HTC) and voluntary medical male circumcision (VMMC) services in 13 countries.Methods: Through a literature search we identified studies that reported facility-level costs of HTC or VMMC programmes. We requested the primary data from authors and standardised ...
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Doomed Interventions: The Failure of Global Responses to AIDS in Africa.
Authors: Ennis B PMID: 31779566 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Smart cascades: using cost analysis to improve HIV care and treatment interventions to achieve global 95-95-95 goals.
Conclusions across countries are synthesised for overall best practices.Results: In Ghana, Indonesia, Tajikistan, and the Kyrgyz Republic, HIV identification strategies need to evolve to counter diminishing testing yields. Higher-yield testing modes may have higher costs per person tested, yet lower costs per person identified compared to previous strategies. In Kenya, investments in linkage and retention require additional funding, and will reduce the need for expensive loss-to-follow-up activities. In Tanzania, differentiated antiretroviral therapy can improve patient management while reducing facility-level costs.Conclu...
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

The state of costing research for HIV interventions in sub-Saharan Africa.
Authors: Cameron DB, Mustafa Diab M, Carroll LN, Bollinger LA, DeCormier Plosky W, Levin C, Herzel B, Marseille E, Alexander L, Bautista-Arredondo S, Pineda-Antunez C, Cerecero-García D, Gomez GB, Dow WH, Kahn JG Abstract The past decade has seen a growing emphasis on the production of high-quality costing data to improve the efficiency and cost-effectiveness of global health interventions. The need for such data is especially important for decision making and priority setting across HIV services from prevention and testing to treatment and care. To help address this critical need, the Global Health Cost Con...
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

The future of HIV and AIDS - a persistent priority.
Authors: Reiszadeh A PMID: 31779569 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

The costs of home-based HIV testing and counselling in sub-Saharan Africa and its association with testing yield: a literature review.
Authors: Hauck K Abstract More than 14.5 of the 36.7 million people living with HIV globally do not know their HIV status, making comprehensive testing interventions a critical step in ending the HIV/AIDS epidemic. Home-based testing and counselling (HBTC) involves small teams of community health workers with basic training going from door-to-door and offering services in people's homes. HBTC is effective in reaching individuals that are unlikely to test otherwise, but there is conflicting evidence on its costs and little insight into why estimates are different. We undertook a comparative review of existing costin...
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Developing the Global Health Cost Consortium Unit Cost Study Repository for HIV and TB: methodology and lessons learned.
Authors: DeCormier Plosky W, Bollinger LA, Alexander L, Cameron DB, Carroll LN, Cunnama L, Gomez GB, Levin C, Marseille E, Mustafa Diab M, Siapka M, Sinanovic E, Vassall A, Kahn JG Abstract Consistently defined, accurate, and easily accessible cost data are a valuable resource to inform efficiency analyses, budget preparation, and sustainability planning in global health. The Global Health Cost Consortium (GHCC) designed the Unit Cost Study Repository (UCSR) to be a resource for standardised HIV and TB intervention cost data displayed by key characteristics such as intervention type, country, and target population....
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Which delivery model innovations can support sustainable HIV treatment?
We describe twelve models for ART delivery, which could be achieved through five categories of delivery innovations: integrating ART ("vertical ART plus", "partially-integrated ART" and "fully-integrated ART"); modifying steps in the ART value chain ("professional task-shifted ART", "people task-shifted ART" and "technology-supported ART"); eliminating steps in the ART value chain ("immediate ART" and "less frequent ART pick-up"); changing ART locations ("private-sector ART", "traditional-sector ART" and "ART outside th...
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

It's politics, stupid! A political analysis of the HIV/AIDS Trust Fund in Uganda.
Authors: Birungi C, Colbourn T Abstract The role of trust funds in the practice of and the policy discourse on the sustainable financing for health and HIV is growing. However, there is a paucity of political analyses on implementing trust fund arrangements. Drawing on a novel meta-framework - connecting multiple streams and advocacy coalition frameworks to policy cycle models of analysis - to politically analyse HIV financing policy design, adoption and implementation as well as insights from public finance literature, this article critically analyses the politics of the AIDS Trust Fund (ATF) in Uganda. We find th...
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Using information on ART costs and benefits to mobilise resources - comparing different methods and contexts.
Authors: Kinghorn A Abstract Sustaining HIV and AIDS responses depends on a mix of donor, government and private funders. Their decisions about investing in HIV treatment may be informed by various types of economic evaluations, which may be more or less useful for different contexts. This paper benchmarks methods against each other. Epidemiological and demographic impacts of HIV and antiretroviral therapy (ART) from 1996-2015 were quantified using country- specific spectrum files. The study compared societal benefits of ART using the full income (FI) methodology with "conventional" benefit, utility and e...
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Planning and sustaining HIV response in the countries of the "risky middle".
Planning and sustaining HIV response in the countries of the "risky middle". Afr J AIDS Res. 2019 Dec;18(4):360-369 Authors: Whiteside A, Greener R, Semini I Abstract This paper focusses on high-HIV middle-income countries termed the "risky middle", i.e. characterised by a typology based on HIV burden and gross national income (GNI), according to which seven countries - Lesotho, Eswatini, Kenya, Zimbabwe, Tanzania, Namibia and Zambia - are identified. There is particular concern for "people left behind", the factors determining a country's ability to mobilise resources in ...
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

HIV testing preferences among pregnant women attending antenatal care and their male partners: a discrete choice experiment in Uganda.
We present the results of a discrete choice experiment in Uganda, examining preferences among 824 pregnant women and 896 male partners regarding service delivery characteristics of HIV testing. Both men and women preferred nurse administered testing to self-testing (OR = 0.835; p
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

A meta-analysis approach for estimating average unit costs for ART using pooled facility-level primary data from African countries.
Conclusion: Our approach allowed us to explore unit cost variation across contexts by pooling ART costs from multiple sources. Our research provides an example of how to estimate costs based on heterogeneous sources reconciling methodological differences across studies and contributes by giving an example on how to estimate costs based on heterogeneous sources of data. Also, our study provides additional information on costs for funders, policy-makers, and decision-makers in the process of designing or scaling-up HIV interventions. PMID: 31779577 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

HIV treatment support services in Tanzania: a cost and efficiency analysis at facility and community levels.
This study assessed the costs of treatment support services at 27 sites in Tanzania. The cost analysis found that the average unit cost of treatment support services is US$39 per patient per year. The analysis found that community-based models have clear advantages with regard to the number of patients that can be reached with support services. Costing data indicated that community-based models are also less expensive. The lack of data on retention limited any conclusions about whether community-based models are the most effective within the Tanzanian context. PMID: 31779578 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Editorial - A sustainable AIDS response: results in the era of shrinking donor funding.
Authors: Forsythe S, Semini I PMID: 31779579 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - November 30, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Do challenges still exist amongst HIV/AIDS patients in managing their condition? A cross-sectional study of 297 participants in the Ethekwini Metro of KwaZulu-Natal, South Africa.
Authors: Naidoo P, Premdutt R Abstract Background: South Africa has the largest HIV/AIDS epidemic globally and the largest anti-retroviral treatment (ART) programme in the world, yet HIV incidence is still chronically high in South Africa, especially in KwaZulu-Natal province (KZN). In light of this, a study was conducted to investigate the extent of challenges making the management of HIV/AIDS difficult in people living with HIV (PLWH) in KZN, South Africa. Methods: A cross-sectional study was carried out with 297 study participants living with HIV and receiving ART from three selected clinics in the Ethekwini Met...
Source: African Journal of AIDS Research - October 4, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Accessing HIV treatment and care services in fishing communities around Lake Victoria in Uganda: mobility and transport challenges.
Authors: Tumwine C, Aggleton P, Bell S Abstract Qualitative research exploring the influence of community-level factors on access to and use of HIV treatment and care services among people living in fishing communities is limited, especially with respect to those already in receipt of HIV care and on treatment. To enhance understanding of these issues, semi-structured in-depth interviews were conducted with 42 HIV-positive fisherfolk and 15 health care providers from two HIV clinics located in two fishing communities in Uganda. Fisherfolk's mobility and poor transport systems were significant barriers to access to ...
Source: African Journal of AIDS Research - October 4, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

"I am aware of the risks, I am not changing my behaviour": risky sexual behaviour of university students in a high-HIV context.
This study uses qualitative data from 20 in-depth interviews and one focus group to examine the risk behaviours of university students aged 18-24 years old, with particular emphasis on understanding the decline in the use of condoms. It is well documented that South Africa has one of the highest prevalence rates of HIV and AIDS in the world, however the findings of this study suggest that even though students were well informed about the perceived risks associated with unsafe sexual behaviours, they continue to engage in risk behaviours including unprotected sexual intercourse, multiple sexual partners and the use of alcoh...
Source: African Journal of AIDS Research - October 4, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Sex work among female workers in the traditional mining sector in Mali - results from the ANRS-12339 Sanu Gundo cross-sectional study in 2015.
Authors: Kounta CH, Sagaon-Teyssier L, Balique H, Diallo F, Kalampalikis N, Mora M, Bourrelly M, Suzan-Monti M, Spire B, Keita BD Abstract Female sex workers (FSW) in mining sites are considered to be at very high risk of HIV infection. We aimed to characterize FSW at the Kôkôyô artisanal gold mining site in Mali, and identify factors associated with sex work using data from ANRS-12339 Sanu Gundo, a cross-sectional survey conducted in 2015 at the mine by ARCAD-SIDA, a Malian non-governmental organisation. People attending HIV-prevention activities were invited to participate in the quantitative an...
Source: African Journal of AIDS Research - October 4, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Social networks, gender and HIV within marriages in Kenya.
This study explores how couples' social networks and spaces of interactions are implicated in the (re)production of gender and gender relations and how this, consequently, shapes HIV risks within marriage. It draws on qualitative data from 14 relatively poor couples from rural eastern Kenya and 13 middle-class couples from the capital city of Nairobi. The data describe couples' networks and address three broad themes: kin relations and gender (re)production; informal financial networks and gender hierarchies; and gender segregation of networks and spaces of interaction. Overall, findings show that much social interaction s...
Source: African Journal of AIDS Research - October 4, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

The relevance of the content of an HIV and AIDS social intervention programme for the youth in the Northern Cape, South Africa.
This study aimed to evaluate the relevance of the content of an HIV and AIDS social intervention programme for the youth in the Northern Cape as well as to collect attendees' recommendations with regards to programme content. The data collection method comprised a group-administered questionnaire completed by youth (N = 172) who participated in the Soul City social intervention programme (SCP) implemented for the youth in the Northern Cape, and recruited through stratified random sampling. Based on specific criteria, the results showed that the SCP programme's content was relevant to the communities it served. The youth al...
Source: African Journal of AIDS Research - October 4, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Associations between female genital mutilation/cutting and HIV: a review of the evidence.
This article reviewed current evidence of associations between FGM/C and HIV, drawing on evidence from peer-reviewed as well as grey literature. All studies evaluated were observational. This review investigated associations between FGM/C and HIV, not a causal relationship, and observational studies therefore sufficed. The final review included 14 studies from several African countries. The strength of the evidence overall was determined to be of low to moderate quality by Department for International Development criteria: conceptual framing, openness and transparency, cogency, appropriateness and rigour, validity, reliabi...
Source: African Journal of AIDS Research - September 11, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Perceptions and attitudes towards acceptability of HIV self-testing among female sex workers in Selibe Phikwe, Botswana.
Conclusion: Improving the uptake of HIVST will require community sensitization, the availability of counselling services, close follow-ups, and the introduction of assisted HIVST approaches. PMID: 31469045 [PubMed - as supplied by publisher] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - August 31, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Obligations of motherhood in shaping sex work, condom use, and HIV care among Swazi female sex workers living with HIV.
Authors: Parmley L, Fielding-Miller R, Mnisi Z, Kennedy CE Abstract Parental obligations influence sexual behaviour among female sex workers (FSW) and may serve as a risk or protective factor for HIV acquisition. How these obligations affect behaviours beyond HIV prevention, including HIV care, is understudied. We analysed 25 interviews conducted with 11 mothers who sell sex and are living with HIV, and 4 key informants as part of a larger study examining the positive health, dignity, and prevention needs of FSW in eSwatini. Despite awareness of HIV reinfection, FSW initiated sex work and engaged in condomless sex ...
Source: African Journal of AIDS Research - July 25, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Community beliefs, HIV stigma, and depression among adolescents living with HIV in rural Uganda.
Authors: Ashaba S, Cooper-Vince CE, Voƙechovská D, Rukundo GZ, Maling S, Akena D, Tsai AC Abstract The availability of and increased access to antiretroviral therapy (ART) has significantly reduced the morbidity and mortality associated with HIV. As a result, perinatally infected youth are increasingly able to reach adolescence. There is limited information about the psychosocial challenges facing adolescents living with HIV (ALWH) in rural settings of sub-Saharan Africa. We sought to understand psychosocial challenges facing ALWH in rural Uganda and their effects on mental health and HIV treatment outcomes...
Source: African Journal of AIDS Research - July 25, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Developing governance models and funding mechanisms of state-civil society partnerships for HIV/AIDS treatment and prevention based on lessons from Ghana.
Authors: Hushie M Abstract The contribution of civil society organisations (CSOs) to national HIV/AIDS responses in sub-Saharan African countries, with Global Health Initiatives' (GHIs) funding channelled through National AIDS Commissions (NACs), is well researched. Less well understood are the governance models and funding mechanisms being used to successfully engage CSOs in the HIV/AIDS response. Using data from government, donor, CSO and documentary sources, this article characterises the organisational principles and practices and unique funding models adopted by the Ghana AIDS Commission (GAC) to effectively a...
Source: African Journal of AIDS Research - July 11, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Perceptions of school principals and experiences of disclosure of teachers living with HIV.
This study utilised narrative inquiry as a qualitative research design that is known to be a way of understanding experiences. Data was elicited via narrative interviews from a purposeful sample of ten principals and eight teachers living with HIV who were selected through network sampling from Gauteng public urban schools. The study found that stigma, fear of job loss and gossip deterred teachers from disclosing their HIV status. In some instances, they disclosed due to needing support, which principals provided in the form of counselling, and also to explain absenteeism. Although principals supported disclosure of teache...
Source: African Journal of AIDS Research - July 11, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Constructions of sexuality and HIV risk among young people in Venda, South Africa: implications for HIV prevention.
Authors: Sivhabu V, Visser M Abstract The study explored constructions of sexuality among young people of Venda in Limpopo, South Africa, and cultural practices that can be used to develop context-specific HIV prevention programmes. HIV prevention can be promoted by including some cultural practices in prevention programmes and changing some aspects of culture that may contribute negatively to health. Six focus group discussions were held with school-going young people (Grades 10 to 12) in urban and rural areas to explore their constructions of sexuality and HIV risk. Four focus group discussions were held with com...
Source: African Journal of AIDS Research - July 11, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Biomedical healthcare and African traditional healing in the management of HIV and AIDS: complimentary or competing cosmologies?
Authors: Mendu E, Ross E Abstract In South Africa, African traditional healers and biomedical practitioners play important roles in the management of HIV and AIDS, but provide healthcare services in isolation of each other, despite legislative recognition of both types of healing. An interpretive, qualitative research approach was employed to elicit the views of both groups regarding the feasibility of collaboration. Semi-structured interviews were conducted with a sample of 20 participants with 10 persons from each group. Key findings were that African traditional healers referred their patients to hospitals but n...
Source: African Journal of AIDS Research - July 11, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Sexual behaviour among adolescents living with the human immunodeficiency virus in Zimbabwe: educational implications.
This study utilised a cross-sectional design with a conveniently selected sample of 341 HIV-positive adolescents. Data were collected through a questionnaire. Data were analysed using descriptive and analytical statistics. The study revealed that approximately 37 (11%) of the adolescents had engaged in sexual intercourse, and approximately 14 (60%) of these did not use condoms. Approximately 11 (30%) of the sexually active adolescents had multiple sexual partners, and only 9 (24.3%) of them had disclosed their HIV serostatus to their partners before sexual intercourse. A bivariate analysis revealed factors that were associ...
Source: African Journal of AIDS Research - July 11, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Evaluation of the early warning indicators of HIV drug resistance surveillance system in Manicaland province, Zimbabwe.
Authors: Marume A, Zikiti A, Chapoterera B, Maradzika J Abstract More than 1.1 million people currently receive lifelong antiretroviral treatment in Zimbabwe following the adoption of the test and treat strategy in 2017. The huge numbers of people on antiretroviral therapy (ART), combined with HIV's error-prone replication, increases the probability of HIV drug resistance (HIVDR) developing. HIVDR in resource-limited settings like Zimbabwe has significant human and financial implications. The early warning indicators of HIV drug resistance surveillance system was set up to monitor the ART programme and to identify ...
Source: African Journal of AIDS Research - July 11, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Feasibility of HIV self-testing: experiences of people seeking HIV testing in rural and urban KwaZulu-Natal, South Africa.
Authors: Harichund C, Kunene P, Moshabela M Abstract HIV status awareness is a rate limiting step in HIV treatment and prevention initiatives aimed at addressing the global HIV epidemic. Uptake of HIV testing remains suboptimal despite global campaigns aimed at improving uptake. HIV self-testing (HIVST) displays the potential to increase uptake of HIV testing in public health care facilities, which are the main access points for HIV testing, but evidence to support this notion is limited. Therefore, this study determined the factors that influence the feasibility of introducing HIVST into public facilities in KwaZu...
Source: African Journal of AIDS Research - July 11, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Management of the Global Fund aid programme in Botswana: challenges and prospects for health services delivery.
This article concludes that the "big brother" relationship of the state in relation to NGOs is crippling the critical and constructive effects of these organisations to deliver needed community-based health services in Botswana. GFTAM represents a window of opportunity for creating an effective civil society whose local activities will not be seen as being led covertly by the state. This article contributes to both theory and practice within the scholarship of development aid in Africa. Qualitative research methods were used, including in-depth interviews with public sector policy makers, all GFATM principal and ...
Source: African Journal of AIDS Research - May 5, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Effect of multiple intervention models on uptake of HIV testing services and sexual behaviour among residents of military cantonments in south-east Nigeria.
This study assessed the effect of on-site multiple HIV control interventions on the uptake of HTC services, knowledge and sexual behaviour among residents of two military cantonments [barracks] in south-east Nigeria. METHODS: A quasi-experimental study was conducted among residents of cantonments in two states in Nigeria. A multistage sampling technique was used to select 350 respondents each at intervention and control sites. A pre-tested interviewer-administered questionnaire was used to collect information. On-site HTC services were established, with the training of HTC counsellors and peer educators. HIV awareness ...
Source: African Journal of AIDS Research - April 18, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

The role of support groups in linking and retaining newly diagnosed clients in HIV care in a peri-urban location in South Africa.
Authors: Kave S, Khuzwayo NF, Hatcher A, Sikweyiya Y Abstract Although South Africa has the largest number of people on antiretroviral therapy (ART) in the world, many HIV clients drop out of care immediately after HIV diagnosis. This qualitative study explored the perceptions and experiences of newly diagnosed clients on the role support groups play in linking and retaining newly diagnosed clients in HIV care in Mbandazayo peri-urban location. The data were analysed using the thematic content analysis approach. Data revealed four mechanisms through which support groups appeared to link and retain newly diagnosed c...
Source: African Journal of AIDS Research - March 20, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

The feasibility of the draw-and-write technique in exploring the resilience of children orphaned by AIDS.
This study involved a convenience sample of 23 IsiXhosa-speaking orphaned children aged from 13 to 17. The participants were in grades 6 to 10 and they resided in two child and youth care centres in the Eastern Cape province of South Africa. As part of the draw-and-write technique the participants were asked to make drawings of what enabled them to cope with their lives and to write short narratives in which they explained their drawings. Inductive content analysis was used to analyse the data and this process yielded two main themes, namely: personal protective resources and socio-ecological protective resources. The find...
Source: African Journal of AIDS Research - March 20, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

The influence of marital status on HIV infection in an HIV hyperendemic area of rural South Africa, 2000-2017.
This study aims to give evidence-based information on the association between marital status and HIV infection in a hyperendemic HIV area in rural South Africa. This study was conducted on longitudinal data collected from the African Health Research Institute (AHRI) based in northern rural KwaZulu-Natal from 2000 to 2017 using multivariable Cox regression. The multivariable Cox regression results found marital status to be a significant factor of HIV infection. Compared to those who were married, the risk of HIV infection was approximately two times in those who were never married while those who were widowed presented as ...
Source: African Journal of AIDS Research - March 20, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Determinants of risky sexual behaviours among adolescents in Central African Republic, Eswatini and Ghana: evidence from multi-indicator cluster surveys.
This study seeks to fill part of this gap by identifying the determinants of risky sexual behaviours among adolescents in Ghana, Central African Republic (CAR) and Eswatini (formerly Swaziland). We used nationally representative sample data from the Multi Indicator Cluster survey, round four (MICS4). Results of the descriptive analysis show that overall consistent condom use is still extremely low in sub-Saharan Africa. In Ghana, only 8.5% of male youth and 7% of female youth consistently use condoms. In CAR this figure is 8% and 4% in male youth and female youth respectively. In Eswatini, with one of highest HIV prevalenc...
Source: African Journal of AIDS Research - March 20, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Informal transit, socio-spatial exclusion, and changing geographies of HIV/AIDS in urban Malawi.
Authors: Mkandawire P, Arku G, Luginaah I, Etowa J Abstract The role played by the transport sector in the regional spread of HIV in sub-Saharan Africa is well known, yet attention has remained confined to entertainment hotspots and stopping places along long-distance highways and cross-border transport corridors. This paper draws attention to informal modes of transit prevalent in sub-Saharan African cities, by linking the rise of two-wheeled, manually operated bicycles, known as "Sacramento", to the potential spread of HIV and AIDS in Malawi. The findings of a qualitative study from Mzuzu city show that...
Source: African Journal of AIDS Research - March 20, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Factors associated with adherence to ARV treatment in people living with HIV/AIDS in a rural area (Koula-Moutou) in East Gabon.
This study reported for the first time the factors influencing adherence to ART in a rural area of East Gabon. We recommend further investigations in a large cohort to better assess the impact of socio-clinical factors on ART adherence in a vulnerable group of patients. PMID: 30880584 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - March 20, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Association between HIV/AIDS knowledge and stigma towards people living with HIV/AIDS in Botswana.
Authors: Letshwenyo-Maruatona SB, Madisa M, Boitshwarelo T, George-Kefilwe B, Kingori C, Ice G, Bianco JA, Marape M, Haile ZT Abstract In Botswana, an estimated 350 000 people live with HIV/AIDS. HIV/AIDS testing rates are low, suggesting that many other people remain undiagnosed. Stigma related to HIV/AIDS is prevalent and contributes to low testing rates and under-diagnosis of the virus. Identifying factors that contribute to stigma, such as insufficient or inaccurate knowledge of HIV/AIDS, may be critical in increasing early identification and treatment. This cross-sectional study used nationally representative ...
Source: African Journal of AIDS Research - March 20, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

HIV prevalence and related behaviours of older people in Botswana - secondary analysis of the Botswana AIDS Impact Survey (BAIS) IV.
Authors: Matlho K, Randell M, Lebelonyane R, Kefas J, Driscoll T, Negin J Abstract The focus of HIV interventions in Botswana, a country with the second highest prevalence of HIV in the world, remains targeted at those aged 15-49 years despite a growing cohort of older people living with the disease - driven largely by the successful roll-out of antiretroviral therapy (ART). Primarily utilising the Botswana AIDS Impact Survey IV, we set out to examine HIV related characteristics and behaviours of this often ignored older cohort (50-64 years) relative to younger (25-49 years) adults. Analysis revealed that more than...
Source: African Journal of AIDS Research - February 21, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

"I don't want them to know": how stigma creates dilemmas for engagement with Treat-all HIV care for people living with HIV in Eswatini.
"I don't want them to know": how stigma creates dilemmas for engagement with Treat-all HIV care for people living with HIV in Eswatini. Afr J AIDS Res. 2019 Feb 19;:1-11 Authors: Horter S, Bernays S, Thabede Z, Dlamini V, Kerschberger B, Pasipamire M, Rusch B, Wringe A Abstract "Treat-all" programmes aim to improve clinical outcomes and to reduce HIV transmission through regular HIV testing and immediate offer of antiretroviral therapy (ART) for those diagnosed HIV-positive, irrespective of immunological status and symptoms of disease. Global narratives on the benefits of Treat-all ...
Source: African Journal of AIDS Research - February 21, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Psycho-educational and social interventions provided for orphans and vulnerable children at a community-based organisation in Soweto, South Africa.
Authors: Sitienei EC, Pillay J Abstract This qualitative study explored the psycho-educational and social interventions provided for orphans and vulnerable children (OVC) in a community-based organisation (CBO) in Soweto, South Africa. The study involved 12 OVC (males = 40%, and females = 60%; aged 10 to 18 years). Data was collected using individual interviews, focus group discussions, and autobiographies. The thematically analysed data revealed that the OVC received psychological interventions through mentorship and peer-group support in the CBO. Educational interventions included the provision of school uniforms...
Source: African Journal of AIDS Research - January 24, 2019 Category: African Health Tags: Afr J AIDS Res Source Type: research

Unpacking the practice of ukujola in contemporary South Africa: understanding informal/casual sexual relations of young African adults in the context of HIV and AIDS.
This study sought to unpack the meaning of ukujola (casual or informal sexual relationships) as socially constructed by Zulu people, and to identify underlying socio-economic factors for ukujola. This study uses a generic qualitative study approach in which 32 qualitative interviews (4 focus groups, 20 in-depth interviews and 8 key-informant interviews) were conducted with isiZulu-speaking participants (aged 21-34) from Umgungundlovu district, KwaZulu-Natal province. The study found that ukujola relationships are a relatively new phenomenon in Zulu society. Ukujola relationships encompass all "illegitimate" relat...
Source: African Journal of AIDS Research - December 19, 2018 Category: African Health Tags: Afr J AIDS Res Source Type: research

Health and AIDS in 2019 and beyond.
Authors: Whiteside A, Wilson D PMID: 30560731 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - December 19, 2018 Category: African Health Tags: Afr J AIDS Res Source Type: research

Stunted scale-up of a performance-based financing program on HIV and maternal-child health services in Mozambique - a policy analysis.
CONCLUSION: There was a generalised ambivalence and lack of incentive to scale-up PBF from the implementing NGO. Coupled with the lack of evidence of a positive effect, and of cost-effectiveness in comparison with other models to improve health service delivery and health system strengthening, it is difficult to argue for the need to scale up the PBF programme studied. Care needs to be taken to base the adoption of health policies, including PBF, on a situational analysis and on evidence of intervention effectiveness, cost-benefits and contextual fit. PMID: 30560732 [PubMed - in process] (Source: African Journal of AIDS Research)
Source: African Journal of AIDS Research - December 19, 2018 Category: African Health Tags: Afr J AIDS Res Source Type: research

Multisectoral (in)action: towards effective mainstreaming of HIV in public sector departments in South Africa.
Authors: Mahlangu P, Vearey J, Goudge J Abstract Whilst progress has been made, evidence of effective approaches to improve action on addressing the social and structural drivers of the HIV epidemic remains a priority, to meet the 2030 sustainable development agenda, and to achieve key HIV targets, including the 90-90-90 target and the Treatment as Prevention (TasP) intervention. With a focus on the public sector in South Africa, we critically reflect on the HIV mainstreaming approach, assessing its ability to augment multisectoral action on the response to HIV. We reflect on progress made in mainstreaming HIV in n...
Source: African Journal of AIDS Research - November 25, 2018 Category: African Health Tags: Afr J AIDS Res Source Type: research

Employees' experiences of the stigma of HIV in a retail organisation: secrecy, privacy or trust?
This study unveiled the participants' experiences of HIV-related stigma in a retail organisation located in the Western Cape province of South Africa. A qualitative approach was adopted because of its appropriateness for unravelling subjective phenomena such as employees' experiences of HIV-related stigma. In-depth interviews were conducted with 10 HIV-positive employees who volunteered to participate. The findings reveal that the participants concealed their HIV-positive status because they feared that the co-workers and managers might stigmatise them and breach confidentiality. The results also revealed that despite bein...
Source: African Journal of AIDS Research - November 25, 2018 Category: African Health Tags: Afr J AIDS Res Source Type: research